Provider Demographics
NPI:1699464768
Name:SYNERGY ACUPUNCTURE, CHIROPRACTIC AND PHYSICAL THERAPY PLLC
Entity type:Organization
Organization Name:SYNERGY ACUPUNCTURE, CHIROPRACTIC AND PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORGANIZER
Authorized Official - Prefix:MR
Authorized Official - First Name:REMON
Authorized Official - Middle Name:
Authorized Official - Last Name:GAD
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:334-545-0412
Mailing Address - Street 1:182 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-3318
Mailing Address - Country:US
Mailing Address - Phone:334-545-0412
Mailing Address - Fax:
Practice Address - Street 1:182 S MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-3318
Practice Address - Country:US
Practice Address - Phone:334-545-0412
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-04
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty